CA lawmakers look to expand scope of some medical professionals

March 14, 2013

The Sacramento Bee

by: Laurel Rosenhall, Bee Capitol BureauCiting a need for more medical professionals able to treat patients who will soon have health insurance under the federal Affordable Care Act, state Sen. Ed Hernandez on Wednesday introduced a package of bills to expand the services that optometrists, pharmacists and nurse practitioners can offer patients.

The so-called "scope of practice" bills set the stage for a massive fight with the state's physicians, who will look to protect their role as gatekeepers to medical care.

In a news conference at a Sacramento health clinic, Hernandez, an optometrist, argued that because of a shortage of doctors in California, other medical professionals should be permitted to offer patients more care.

"Here in the state of California we have a capacity issue. We have a workforce shortage," said Hernandez, D-West Covina, adding that the problem is most severe in rural and inner-city areas.

With the federal health care overhaul kicking in, he said, nearly 5 million Californians who don't now have health insurance will be required to be insured as of next year.

"How is it that we're going to be requiring somebody to purchase health insurance, but yet they won't have access to a doctor?" Hernandez said. "This is what we need to address."

Hernandez's proposals will soon be spelled out in Senate Bills 491, 492 and 493. Sen. Fran Pavley, D-Agoura Hills, is also working on Senate Bill 352, which would expand the scope of practice for physician's assistants.

The group that lobbies for the state's doctors responded by saying California should focus on policies that will create more doctors – not allow medical workers with less training to expand their practice.

"A huge concern of ours is this notion of patient safety," said Molly Weedn, a spokeswoman for the California Medical Association. "These allied health professionals definitely play a very important role in the health care delivery system. … But doctors are highly trained professionals who have been taught to diagnose and treat their patients."

People expect that the insurance they purchase will buy them a visit with a doctor, Weedn said, adding that any care by other kinds of medical professionals should be overseen by a physician.

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